My headaches come and go, but lately they are more frequent and more intense. I’ve heard serious problems like aneurysms can cause headaches. How do I know if it’s serious or not?

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Q: My headaches come and go, but lately they are more frequent and more intense. I’ve heard serious problems like aneurysms can cause headaches. How do I know if it’s serious or not?

July 3, 2014

First, it’s important to figure out what type of headache you’re having. Many people go to the doctor with what they think is a leftover cold or sinus headache, only to find out they’ve been having migraine headaches. Migraine headaches are more common in women; in fact, about three fourths of all migraine sufferers are women. Migraines can be disabling. They disrupt your life with throbbing pain, nausea, dizziness, sensitivity to light, sensitivity to smells and vision disturbances. A migraine is a real problem, but one that has real solutions. While they can be triggered by a number of things, the important message is you don’t have to suffer. A neurologist can help you find the cause of your headache and avoid triggers as well as treat the symptoms at the onset, before they worsen.

In some cases, there are serious medical issues that can cause pain similar to a migraine headache. Any headache that disrupts your life should be taken seriously. As a neurovascular surgeon, I’ve treated patients who described pain that turned out to be caused by a brain aneurysm, as “the worst headache” of their lives. An aneurysm is a balloon that forms in a blood vessel. The balloon can rupture and, if the aneurysm is in the brain, cause a bleeding (hemorrhagic) stroke. Because of the widespread use of non-invasive imaging technology, we’re able to detect aneurysms that have not yet ruptured in about 50 percent of the cases. Most people with a brain aneurysm find out after it ruptures, unfortunately. However, they can be found “by accident” when people are being scanned for other conditions. Today, there are effective treatments to help people in these difficult situations.

There is no need to be alarmed. But you are right to ask questions and to not dismiss any pain. Only about 4 percent of the population harbors a brain aneurysm. People with immediate family members who have had an aneurysm are at increased risk, and they are usually monitored regularly. See your doctor and have a detailed discussion about the severity and frequency of your headaches. I bet that, together, you can come up with some answers.

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